摘要
目的：研究手足口病患儿的血清细胞因子水平的变化情况，并探讨免疫球蛋白治疗的临床意义。方法对我院2012年5月至2013年6月收治的262例手足口病患儿临床资料进行回顾性分析，将其分为普通组和重症病例组，总结HFMD患儿的临床特点，进行病原学检测，同时采用Luminex液相芯片方法检测2组患儿血清中的5种细胞因子，包括IL-2、IL-6、IL-10、TNF-α和IFN-γ，对于部分危重患儿给予免疫球蛋白治疗，并观察细胞因子水平变化。结果普通组109例，重症组153例。与普通组相比，重症组IL-2、IL-6、IL-10和TNF-α明显升高（18.02 ng/L vs 22.71 ng/L、28.42 ng/L vs 53.76 ng/L、17.92 vs 42.37 ng/L、102.29 vs 207.99 ng/L，P＜0.05），而IFN-γ在两组无统计学差异（325.51 vs 373.78 ng/L，P＞0.05）。对于符合危重病例标准的40例患者给予免疫球蛋白治疗后，检测发现IL-2、IL-6、IL-10、TNF-α和IFN-γ水平均明显下降（ P＜0.05）。结论手足口病重症病例存在细胞因子水平的异常变化，而静脉给予免疫球蛋白治疗可以降低细胞因子水平，可能有助于改善预后。
Objective To investigate the changes of cytokines in hand-foot-and-mouth disease（ HFMD） patients.Methods Retrospective analysis was performed on the clinical data of 262 cases of HFMD.All 262 children with HFMD were divided into two groups：severe cases and non-severe cases.Five cytokines（ IL-2,IL-6,IL-10,TNF-αand IFN-γ） simultaneously were detected by luminex multiplexed assays.Results There were 153 severe cases and 109 non-severe cases,The results showed that the levels of IL-2,IL-6,IL-10,TNF-αin severe cases were higher than non-severe cases,and the differences were significant （18.02 ng/L vs 22.71ng/L, 28.42 ng/L vs 53.76 ng/L,17.92 ng/L vs 42.37 ng/L,102.29 ng/L vs 207.99 ng/L,P〈0.05 ） .No significant difference of IFN-γlevel was found between the two groups（325.51 vs 373.78 ng/L,P〉0.05）.In 40 critical cases,plasma levels of IL-2,IL-6,IL-10,TNF-α,and IFN-γwere significantly decreased after administration of intravenous immunoglobulin（ P〈0.05 ） .Conclusion Some cytokines increase in children with severe HFMD, indicating that inflammatory and anti-inflammatory reaction may play importent roles in the pathogenesis of severe HFMD.The findings suggest that intravenous immunoglobulin might play a therapeutic role in severe HFMD.
出处
《国际儿科学杂志》
2014年第4期427-430,共4页
International Journal of Pediatrics
关键词
手足口病
细胞因子
免疫球蛋白
临床分析
Hand-foot-and-mouth disease
Cytokines
Intravenous immunoglobulin
Clinical analysis
